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SAN FRANCISCO (CBS 5) — In a time of need, an ambulance can save your life. But if an ambulance arrives, and you’re not injured, the bill can leave a lasting pain.

Siran Nahabedian remembers it clearly, the day a red light runner hit her car. “The police came, the ambulance came,” she said.

Two other drivers suffered minor injuries. She was fine, and so was her son Michael. But a few days later she received a bill in the mail. It was two invoices for $1,500, for her and her son, from the King American ambulance company.

“It was $3,000 for both of us. My first reaction was there must be some sort of a mistake because on that day I wasn’t hurt, I wasn’t transported, I did not call the ambulance company,” said Nahabedian. But the company insisted it wasn’t a billing error.

After weeks of complaints King American said, as a “courtesy” it would drop her son’s charges. But she still owed $1,500. “They were not going to back down,” she said. They tried to convince her to simply bill her insurance company.

And when she refused out of principal, they sent her to collections. The 4th grade teacher received calls at her school, threatening wage garnishment.

It turns out, technically that message from debt collector is correct. By simply signing a refusal of service form that releasing the ambulance of liability you can be responsible for a bill. In fact you may be, even if you don’t sign it.

Rob Dudgeon oversees Emergency services for the city and county of San Francisco and confirms that it’s perfectly legal for ambulance companies to send a bill in those situations.

“They provided a response, they arrived, they used a resource to at least go to this location so it is usually in their best interest to try to recoup the cost,” Dudgeon told CBS 5 ConsumerWatch.

But how much you get billed, depends on who responds. CBS 5 ConsumerWatch compiled a database which shows, nationwide, minimum fees without transport range from $140 to $5,000. Some of the highest fees are in cities such as San Francisco, which has an open 911 system.

So it’s the luck of the draw. If fire department paramedics respond they charge a base rate of $365, but will usually not bill you if you’re not injured and didn’t call.

But if one of the private ambulance providers show up, everyone on the scene will most likely get billed, for a lot more. “We don’t get into regulating billing practice,” Dudgeon said.

King American’s chief paramedic Josh Nultemeier said as a private company they have to charge more because unlike the fire department, they don’t get public subsidies. “We get zero tax money from the city and we actually have to pay tens of thousands of dollars to have the privilege to operate in San Francisco,” he said.

Nultemier also cited the high number of homeless and uninsured. “50 percent of the calls we go on we don’t get any re-imbursement for,” he said.

How does he make up for it? “The insured pay,” Nultemeier said. “The insurance companies get billed at higher rates to make up for the people that didn’t have the insurance. That’s the unfortunate truth.”

Nahabedian said, “It just didn’t seem right. I mean this is how our premiums go up. It’s just not fair.” She claims she never even spoke to a paramedic. “No interaction whatsoever. They were busy tending to the other person,” she said.

But Nultemeier said by simply being there she did receive a service. “Somebody called 911 and we went there because of that person they received a response,” he said.

So, why bill Nahabedian for non-treatment, when two others were billed received treatment? “That’s pretty much standard practice,” said Nultemeier.

Nahabedian’s reaction: “I was liable, just for being at the wrong place at the wrong time.”

King American has since removed the collections notice from Nahabedian’s account. And as a result of her case they say they have changed their billing practices, lowering their minimum fee from $1,500 to $385, more in line with the San Francisco Fire Department’s charges.

(Copyright 2011 by CBS San Francisco. All Rights Reserved. This material may not be published, broadcast, rewritten, or redistributed.)